Between+XX+and+XY:+Intersexuality+and+the+myth+of+two+sexes

In the end to some lenore was the puzzle of intersex

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Unformatted text preview: scalpeled and hormoned Lenore—a 46,XY person—into a girl. With the hormones given her, Lenore’s facial hair cleared up and her breasts began to grow, gracing her chest with one of the most noticeable badges of womanhood.1 But of course none of this really solved the problem, if in fact there ever was a problem that needed solving. In the end, to some Lenore was The Puzzle of Intersex 7 clearly a girl. At the same time, to others Lenore remained a boy. But Lenore was neither. What, then, should we call Lenore? Dr. Betty Suits Tibbs’s report ends with Lenore in the tenth grade— maybe sixteen years old. Dr. Tibbs observed, “The patient is in tenth grade at present and has made a very good adjustment. It is felt that with her drive and capacities, the prognosis for her identity as a woman is quite good.” The rest of Lenore’s story we can only imagine. Every year in the United States, approximately one thousand babies are born with cystic fibrosis and about four hundred are born with hemophilia. Few of us have to ask what hemophilia or cystic fibrosis are. We might not fully understand what causes these disorders, but we know that either one can make a person’s life very difficult. Curiously, no one seems to know just how many babies of indeterminate sex like Lenore are born in the United States every year. Estimates range from one thousand to fifteen thousand. It seems probable that the correct number is nearer to the lower estimate than the higher one. Regardless, it is a substantial number of people. We now refer to these people collectively as intersex, or people with disorders of sex development (DSDs). The birth of an intersex child is a difficult event for family and physicians. They must select, from very few options, the least-bad alternative with the hope that, even in their ignorance, even with the paucity of language available to speak about these children, even under the weight of history and fear, they may create a better future for their new child. Surprisingly, until very recently, standard practice usually excluded the child and the parents from the decision-making process. The physicians made the choice of boy or girl and did what they could do to ensure that the child would walk that path for the rest of his or her life. Physicians believed they knew best and that the input of others was unnecessary. They believed that the fewer who knew about what had happened at birth, the less likely it was that someone might raise the veil so carefully woven and placed by their hands. 8 Between XX and XY As a result, for years hardly anyone outside the medical community had heard of the thousands upon thousands of children like Lenore. And even today, most of us hear little about these people who, like Lenore, fall through the cracks in our language and raise serious questions about our cast-iron ideas about two opposite sexes. Maybe we don’t hear much about these people simply because we don’t want to hear about them. They make us even more uneasy about things we are already sufficiently uneasy about—things like human sex. But regardless of our discomfort, these are people, and their stories are important, because wrapped up inside of them is a secret that all of us should know, a secret about what it truly means to be human. 2 A Brief History of Sex In many ways Lenore’s future was laid out years before she was born. As Dr. Brown and his colleagues pondered Lenore’s situation, millennia of human thought about sex and intersex molded their ideas. As long as human beings have walked upright, we’ve been thinking about how we acquire sex, how we have sex, and why we need sex. And though most of us may believe that humans have always thought in more or less the same ways about the sexual character of human beings, history doesn’t support that assumption. In fact, we have not even always believed that humans come in two, and only two, opposite sexes. Ancient Greek Sex (c. 450 B.C.–A.D. 200): The Power of One Our access to musings about the biology of human sex begins about twenty-four hundred years ago with people like Hippocrates (c. 460–c. 377 B.C.), Aristotle (384–322 B.C.), and Galen (A.D. 129–c. 199). Hippocrates, the father of medicine, forced the first separation of religion and science. He argued for the natural origins of disease and death and shunned the gods. He was a logical man and a careful observer of humankind. Nothing he proposed originated from fancy or spur-of-themoment decisions. He was thorough and methodical. 9 10 Between XX and XY Hippocrates proposed that menstrual blood and sperm were in essence the same substance. Women shed menstrual blood, he said, when an excess of nutrients accumulated in the blood. Men, instead, refined blood foam into sperm and passed it along to the brain. The sperm then made its way through the spinal marrow, into the kidneys, to the testicles, and finally into the penis itself. Hippocrates clearly saw differences between men and women, but for him the diffe...
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This document was uploaded on 02/04/2014.

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